It has been proposed (see U.S. Pat. No. 3,516,409 and German Pat. 3,444,782) to utilize principles of a slide fastener for the closing of a wound and, in particular, surgical incision which is generally linear.
The term "wound closure" and terms of similar import are used in the sense of the invention to mean that a gaping incision having the edges of the wound normally spread apart, is used to bring those edges into abutting relationship so that there can ensue a wound-knitting or healing procedure. It is not intended to apply to the covering of a wound which is closed by other means and thus the wound-closure device and method of the invention can be used to close a wound without the stitches or clips which have hitherto been necessary and which can be entirely eliminated utilizing the principles of the invention.
While generally the invention should be considered to be compatible to the body of any living subject in which a surgical incision may be made, in the most common case the body will be that of a human patient or an animal under veterinary care.
When a slide fastener is referred to herein, it will be understood that a device is intended which comprises a pair of tapes, generally of fabric or textile material, along juxtaposed edges of which coupling elements can be provided which are capable of mating with one another upon movement of a slider along the coupling elements. The coupling elements can comprise rows of interdigitatable coupling members whose coupling heads fit between one another and can be separated from one another by movement of the slider in the opposite direction.
In the known device which utilizes the principles of such slide fasteners to close a wound and is described in the aforementioned patents, the slide fastener is a specially provided slide fastener with specially designed tapes and which can be distinguished form conventional slide fasteners of types which have been widely used in the textile trades and which can be described as garment-type slide fasteners.
The specially designed tapes of the prior-art slide fastener have adhesive layers applied directly thereto or coated directly thereon.
Such slide fasteners have not gained acceptance in clinical practice because the special fabrication techniques required for these slide fasteners has made them too expensive for use. In addition, the early devices appear to result in some interaction between the coupling elements and the wound edges causing the adhesion of the coupling elements or the tapes to the wound, scarring and imperfect healing.
Furthermore the earlier devices cannot ensure effective draining of wound secretions because of the latter, and because of the intrinsic characteristics of the construction used, the adhesive bond with the skin tends to release prematurely.
If one applies a cover strip over the conventional wound-closing slide fastener, the pressing of the tape or the coupling elements against the wound cannot be prevented and unesthetic scarring can result from the resulting tendency of the wound to grow onto or into the device.
It has been proposed to increase the adhesion of the tape to the skin to provide the tape with a row of needle-like pins which can be pressed into the skin while the slide fastener is open. This of courses discomforts the patient or the animal and can also give rise to visible scarring.
With respect to the method for closing the wound using particular devices of the above-mentioned patents, it may be mentioned that first a wound must have its edges pressed together by hand and then the slide fastener is closed. This is a considerable drawback because even the method of utilizing the conventional slide fastener is awkward.
For all of these reasons, the slide fastener wound closures of the prior art have only been applied in abdominal surgery (see Neue Zuricher Zeitung" of Aug. 22, 1984, "Hamburger Abendblatt" of Whitsuntide 1984), and only for the temporary closure of a wound in the case in which reopening may be required, in the case of peritonitis, pancreatic failure or the like. Even in these cases, to ensure the development of the healing process, the wound closure must be effected by the classical stretching or use of clips and thus the prior art device has not been found to be suitable as a substitute for such classical closure methods.